In terms of medicine and becoming a doctor, the consequences of patriotism, nationalism, was in full force in 1800. When the first yellow fever epidemic in nearly 30 years struck Philadelphia and then New York in 1793, the first year or two of these events were simply considered the consequences of poor climate and topography. There were however those who felt that the rapidly growing urban settings of these region could be the cause.

When the yellow fever returned in 1797, the result was tens of thousands of people fleeing the city of Poughkeepsie, and probably just as many escaping the equally unhealthy New York atmosphere riddled with contagion. This influx of such a deadly epidemic led physicians in these two city settings to develop their first Quarantine practices and laws. The resulting first public health movements in the United States led to a reduction of the fever in New York and Philadelphia, but in the long run had minimal effects upon the global migration of this epidemic disease, now in the process of defining several new territories.

In Great Britain, the residents were pretty much free of the severely deadly versions of yellow fever so fatal to North Americans and especially United States citizens. This was due in part to the distance that had to be travelled and latitudes crossed between the fever’s original focus, the West Indies, and the first shipping ports in Europe. Any such epidemics on board tended to die off by the time these ships came to western Europe. In the eyes of European doctors, the contagion or miasma/effluvium on board was washed away by the ocean breezes by the time these ships entered their first European harbors, or better yet, by the cold nights at sea.

Meanwhile, other towns in the United States situated along inland transportation routes began to demonstrate the consequences of the yellow fever diffusion process. The first diffusion of this disease inland took place mostly along the Hudson River, but there were equally as many inland routes high susceptible to this epidemic. French medical georapher Valentin had something to say about this

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In his Treatise on Yellow Fever in America, Valentin notes several routes inland for the fever, a topic very popular around this time due to the ongoing attempts to lay claim to the remaining unsettled territories in western New York, westward through the former lands of New France, extending further west as far as the explorers and settlers would take themselves. Note in the above pages Valentin’s reference to the Genesee River, the Finger Lakes, the Great Lakes, the Housatonic and Lake Champlain. Both the Genesee and Seneka regions had their own fevers assigned to them, which Valentin infers may simply be more examples of the yellow fever.

The more heavily populated regions north of New York along this North River were the first to witness cases and people on board infected ships taking their first steps in upstate New York settings. For the most part these epidemics were not at all comparable to the serious epidemics striking the big cities down below. But these local cases were enough to confirm some of the findings and suspicions out there about yellow fever and its potential causes. This article is one such example of this study of Yellow Fever epidemiology and medical geography.

The local diseases in New York’s urban and rural settings made this state a very different place to learn medicine when compared with Europe. Until now, one received additional respect for undergoing an education in medicine such famous cities as Paris, London, or Edinburgh. This time, the source of fame would be different. The best New York doctors were those trained and raised in New York’s natural setting. Likewise the best Philadelphia doctors were raised and trained in their own home town settings. How else could a physician better understand his local environment, climate and topography in relation to the local disease patterns, whilst living the most appropriate way, in the most healthiest of these many local settings.

In American medicine, nationalism was reaching a peak just before the commencement of the War of1812. To New Yorkers, the best medicine to be learned was that of the immediate tri-state region. Samuel Mitchell the chief editor of the Medical Repository and a local Congressman believed in and heavily promoted this philosophy in United States medicine. The numerous articles he had published on the local medical topography and geography in part were to support his new theories of disease which he promoted, but also played some professional political role in his life as well as the lives of other New York physicians about this time. These articles helped make very popular Samuel Mitchell’s theories of disease. Meanwhile, his local associate and competitor of the medical press, Benjamin Rush, was making his own progress promoting a number of his own philosophies in medicine and epidemiology.

Comparing Philadelphia’s first major epidemic with that of New York, Rush may have made his interpretations on Yellow Fever very popular and even famous, but Mitchell earned the most reputation in terms of this disease by flooding the medical j urnals with numerous new theories for endemic and epidemic disease. This makes the majority of Mitchell’s articles most important readings for understanding the history of Early Americana in relation to medical geography.